替格瑞洛对急性ST段抬高型心肌梗死患者血清hs-CRP和ESM-1水平的影响及短期预后观察

发布时间：2019-04-10 13:57

【摘要】：目的观察并探讨替格瑞洛治疗下急性ST段抬高型心肌梗死(STEMI)患者血清高敏C反应蛋白(hsCRP)和内皮细胞特异性分子1(ESM-1)的水平变化及短期预后。方法入选首次发生症状并成功行急诊PCI的急性STEMI患者107例,按双抗血小板治疗时是否应用替格瑞洛将患者分为替格瑞洛组54例和氯吡格雷组53例,观察两组患者入院即刻、服药后24 h、第4天及第7天hs-CRP和ESM-1的水平变化以及二者是否具有相关性,同时观察替格瑞洛对急性STEMI患者短期预后的影响。结果两组患者hs-CRP和ESM-1水平在服药后24 h均有明显上升,两组间比较有统计学差异(P0.05);服药后第4天、第7天hs-CRP和ESM-1水平均呈下降趋势,两组间比较差异均有统计学意义(P0.05);ESM-1随hs-CRP水平升高而升高,ESM-1与hs-CRP呈正相关(r=0.535,P0.001);替格瑞洛组与氯吡格雷组患者在缺血终点事件、出血事件以及总不良事件的发生率上比较均无统计学差异(P0.05)。结论替格瑞洛在STEMI患者治疗中能够更加迅速降低细胞炎症反应并稳定血管内皮,从而改善动脉粥样硬化斑块的稳定性,减少血栓的形成及缺血终点事件的发生且并不增加明显出血风险,值得临床推荐使用。
[Abstract]:Aim to observe and investigate the changes of serum Gao Min C reactive protein (hsCRP) and endothelial cell specific molecule 1 (ESM-1) levels and short-term prognosis in patients with acute ST segment elevation myocardial infarction (STEMI) treated with tigrilol. Methods A total of 107 patients with acute STEMI who developed symptoms for the first time and successfully underwent emergency PCI were divided into two groups, 54 patients in the tigrilol group and 53 patients in the clopidogrel group. The patients in the two groups were observed immediately after admission according to whether the patients were treated with tigrilol or not. The changes of the levels of hs-CRP and ESM-1 at 24 h, 4 d and 7 d after treatment and the correlation between them were observed. The short-term prognosis of acute STEMI patients was also observed by observing the effect of tigrilol on the short-term prognosis. Results the levels of hs-CRP and ESM-1 in the two groups increased significantly at 24 h after treatment, and there was statistical difference between the two groups (P0.05). The levels of hs-CRP and ESM-1 decreased on the 4th and 7th day after administration, and there was significant difference between the two groups (P0.05). ESM-1 increased with the increase of hs-CRP level, and there was a positive correlation between ESM-1 and hs-CRP (r = 0.535, P0.001). There was no significant difference in the incidence of ischemic end point events, bleeding events and total adverse events between the tiglil group and clopidogrel group (P0.05). Conclusion Tigrilol can improve the stability of atherosclerotic plaques by reducing the cellular inflammatory response and stabilizing the endothelial cells in patients with STEMI. Reducing thrombosis and ischemic end-point events without significantly increasing the risk of bleeding is recommended for clinical use.
【作者单位】：东南大学附属徐州市中心医院心内科;苏州大学附属第一医院心内科;第二军医大学附属上海长海医院老年科;赣州市人民医院心内科;
【基金】：江苏省青年医学人才项目资助(QNRC2016382) 徐州市社会发展项目资助(KC16SH028)
【分类号】：R542.22

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